Patients and their families want to know how they can improve the quality of hearing aid fittings. Our topic for today, “Patient Notes,” is one way we can markedly improve all aspects of the experience our patients have with the hearing aids we give them. Written notes help ensure that we do not miss or neglect critical “hearing issues.”
This article was inspired by a patient I saw the other day. When Cliff came into my office, he handed me the following written list of comments and questions:
- Program 1 is okay
- Program 2 does not work; I can’t hear any difference between 1 and 2.
- The “beep” in program 1 in the left ear is weak.
- The manual says a low battery indicator can be programmed into the hearing aids. How do I activate it?
- Program 3 works great.
- What was that “hole” in the case you told me about?
A quick perusal of his notes told me that the basic fitting (the sound programmed into Program 1) was working well, but I needed to adjust Program 2. His notes also told me that I had accidentally set the level of the “beeps” too low in Program 1 in the left ear.
As for the missing low battery indicator, once Cliff told me about it I was quickly able to diagnose the problem. His remote control comes with a plastic case. When you put the case on the remote control, the low battery light is no longer visible.
There is a simple solution: You drill a hole in the plastic case so the patient can see the indicator light. I had forgotten to do this when I gave Cliff his hearing aids. Fortunately, his notes reminded me to fix the situation.
WRITTEN NOTES ARE INVALUABLE
Not all patients are willing to write notes. In the case of men, often the wife volunteers for this task, and her efforts are usually invaluable.
When you rely entirely on talking with patients about their fitting the results are often not very helpful. For example, if you ask, “How are your hearing aids working?” you get simplistic answers like “Fine.” An attentive, supportive spouse will supplement this response with comments like, “Don’t forget about the restaurant we went to yesterday. Tell the doctor what happened when you tried using your hearing aids there.”
Hearing aids have improved in many different dimensions. For example, we can now connect patients with their telephone using both ears, and we can choose the amount of background noise heard during a telephone conversation by carefully selecting microphone–telephone control settings. If the patient understands the benefits, we can often completely eliminate environmental noise during a telephone conversation by de-activating the microphone.
Hearing aids are crucial in determining how well people cope with many different listening situations, e.g., watching television, eating in a restaurant, using the phone, communicating in a noisy classroom. If the hearing aid wearer or a family member takes written notes about the hearing problems and successes encountered in day-to-day life, we as audiologists can grasp the “big picture” much more quickly. Notes save time and headaches both for our patients and for us.